Mindfulness Therapy for ED Feasible, Warrants Further Research

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2 December, 2018

Mindfulness-based group therapy is a feasible method for treating men with situational erectile dysfunction (ED), according to a recent pilot study in the Journal of Sexual Medicine.

The therapy, which involves “non-judgmental present-moment awareness” has been beneficial for women with sexual dysfunction in the past, as it reduces anxiety and sexual distress. However, little was known about its effects on men with ED.

As the name suggests, situational ED occurs only in certain situations or contexts. For example, a man might experience situational ED if he is under stress, in conflict with his partner, or under the influence of alcohol.

The study involved ten men (average age 40) who had had situational ED for at least six months. The men attended four weekly mindfulness treatment sessions lasting 2.25 hours. Each session incorporated psychoeducation, sex therapy, and the teaching of mindfulness skills. The men were also assigned practice activities to do at home.

Participants completed a series of questionnaires, including the International Index of Erectile Function (IIEF) before the study began, immediately following treatment, and six months after treatment. Five of the men also participated in exit interviews.

The authors identified six themes from the interviews:

Normalization. Men generally felt that the group therapy setting helped validate their personal experiences. They also felt that there was a logical rationale for this type of therapy.

Group magic. The men felt that the group setting was a “safe” and “supportive” place and an “outlet” to share their experiences. Accountability encouraged them to do their home practice.

Effective treatment targets. The men said that mindfulness therapy helped them become more aware of their situational ED triggers, such as performance anxiety. They also noted other targets, such as staying focused. (One man called this target “clearing away the cluttered thoughts.”)

Increased self-efficacy. “Across the board, men reported that learning practical tools to cope with their ED provided a sense of hope and allowed self-acceptance,” the authors wrote. Men also said that they could apply the skills they had learned in therapy to other aspects of life.

Relationship factors. Men said they learned the importance of partners in the ED treatment process; however, the authors noted that men who are not in relationships may need special consideration.

Barriers to effective treatment. All of the exit interviewees said that they would prefer a program that was longer than four weeks. They also wished to have more time available to discuss their experiences with one another.

The study was not designed to assess treatment efficacy. In fact, the men’s erectile function had not changed significantly at the four-week follow up. A “medium effect in the direction of improvement” was noted at the six-month follow up, but IIEF scores still indicated sexual dysfunction.

However, the authors reported a “large increase” in satisfaction with overall sexual function at the six-month point. “This observation suggests that even a brief mindfulness-based intervention may result in improvements to men’s ability to better enjoy their sexual lives, despite no significant change in self-reported ED symptomology.”

Further research to explore the efficacy of mindfulness-based therapy in men with situational ED was recommended.